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11 Cards in this Set
- Front
- Back
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The first thing the lumen of the esophagus does when it's obstructed is what? What does this mean re: presentation of cancers?
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dilates
they will present w/sx later. |
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What is the most common sx of esophageal cancer?
- does it present with weight loss? + what might that indicate? - Are chest pain, GI bleeding, and SOB freq or infreq? |
almost always w/dysphagia
- sometimes + metastatic dz - infreq, but still possible. |
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Which is more common in the esophagus, adenocarcinoma or SCC? Which has been increasing in freq? Which is the bigger concern internationally?
What ages groups do they occur in? |
approx equally common.
Adenocarcinoma SCC Both occur in older individuals (ave age of onset app 70 yo) |
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Tell me whether the following pts are more likely to have adenocarcinoma or SCC of the esophagus:
1. hx of GERD --> Barrett's 2. AA pt from NC 3. white pt from New Jersey 4. Pt w/ hx of toxic ingestion 5. Alcoholic 6. Pt w/ 30 year smoking hx |
Adeno
SCC Adeno SCC SCC SCC |
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What else is considered on the DDx list for esophageal cancer?
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--> includes:
Esophageal strictures Extrinsic compression of the esophagus (other cancers, aneurysms, etc) Viral infection of the esophagus Benign esophageal growths Erosive esophagitis |
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How must dx of esophageal cancer be made?
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Endoscopy
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CT scan, MRI and EUS often used to assess what in pts w/ confirmed esophageal cancer?
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the extent of the tumor
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Is Adenocarcinoma a distal or proximal condition in the esophagus? why?
SCC? |
distal, b/c that's where Barrett's happens.
proximal/medial |
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What tx offers the best hope for a cure in esophageal cancer tx? Risks?
Is Xrt/Chemo used? |
Resection offers best hope for cure
- this is a tough surgery, 30-40% morbidity, 2-5% mortality. usually palliatively, occasionally curative - can be adjuvant |
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Do most esophageal cancers present at a curable stage? Why might prog in these cancers be so especially poor?
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no.
Cancer in the esophagus spreads earlier to local structures b/c the esophagus doesn't have a serosa. |
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leiomyomas
esophageal cysts fibrovascular polyps papillomas granular cell tumors Lipomas ... all are what? are most mucosal growths? What type of imaging can help determine histology? |
benign growths in the esophagus
no, submucosal. EUS |
